Individual provider Active NPI

Traci Lee Thomas, D.O.

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1538259791
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4376 Issued in OK
Practice address
7410 Macarthur Blvd
Oklahoma City, OK 73169-1412
Phone
(405) 682-4075
Fax
(405) 680-4476
NPI assigned
Oct 16, 2006
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4376 OK Primary

Addresses

Primary practice location

7410 Macarthur Blvd
Oklahoma City, OK 73169-1412

Mailing address

7410 Macarthur Blvd
Oklahoma City, OK 73169-1412
Phone (405) 682-4075

Other identifiers 1

IdentifierTypeStateIssuer
8EF185OtherOKMEDICARE

Other names 1

  • Traci Lee Carney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161220002462 OK Order and Referring Only - Family PracticePractitioner - Family Practice 9739273715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Federal Transfer Center Oklahoma City CurrentSince Jan 28, 2024 Accepting new patients
Midway Medical Clinic Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

7410 S MacArthur Blvd
Oklahoma City, OK 73169
Phone (405) 680-4075

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1538259791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731691412",
            "telephone_number": "405-682-4075",
            "fax_number": "405-680-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 MACARTHUR BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731691412",
            "telephone_number": "405-682-4075",
            "fax_number": "405-680-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TRACI",
        "middle_name": "LEE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "8EF185",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "CARNEY",
            "middle_name": "LEE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.